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What is a Non-Progressor?

The introduction of protease inhibitors and antiretroviral drugs has helped to make HIV a chronic condition for non-progressors, who do not progress to AIDS.
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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 17 November 2014
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A non-progressor is someone who has been infected with the Human Immunodeficiency Virus (HIV) for seven to 12 years without developing full-blown AIDS. Researchers estimate that around one in 100 HIV patients is a non-progressor, and an even smaller number of people are “elite controllers” capable of suppressing their viral loads for extended periods of time. A great deal of research has been conducted on long-term non-progressors and elite controllers, with the goal of understanding why the disease does not progress in these individuals, and if non-progressors could hold a key to a treatment or cure for HIV/AIDS.

In order to be considered a non-progressor, someone must have stable CD4 counts within a normal range, and he or she must have no HIV/AIDS-related infections. Non-progressors have also never been treated with antiretroviral therapy in an attempt to suppress the disease. Some researchers consider a patient to be a non-progressor after seven years, while others prefer to wait 12 years before classifying someone as a non-progressor.

Although the progress of the disease appears to be slowed or even stopped in long-term non-progressors, they can still develop AIDS. AIDS can emerge 15 to 30 years after the onset of HIV infection in some cases. Because of this, non-progressors must receive regular medical treatment and CD4 counts to make sure that they are still in non-progressor status.

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A number of theories have been posited in an attempt to explain why some people become non-progressors. Originally, researchers thought that non-progressors were infected with less virulent forms of HIV, but this theory has since proved incorrect. Non-progressors appear to have lower levels of HIV in their lymph nodes, which may have something to do with it, and some researchers have suggested that perhaps non-progressors produce effective antibodies against the virus. While everyone infected with HIV/AIDS develops antibodies, the antibodies are usually ineffective, so if the antibody theory is correct, it may mean that a vaccine is possible. There may be a strong genetic component involved as well, although more extensive research on the genomes of long-term non-progressors would be needed to support this theory.

Elite controllers are sort of like the gold stars of the long-term non-progressors. Some elite controllers have viral loads so low that they are almost undetectable, which means that their bodies are definitely fighting HIV in some way. Learning how elite controllers suppress the virus in their bodies could be a critical step in HIV/AIDS research.

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Mammmood
Post 4

@SkyWhisperer - If you fall into the category where you are infected and yet don’t develop AIDS for thirty years, you might be tempted to think that you have been cured.

I think it’s good to never make that assumption, regardless of whether you experience an AIDS symptom or not. Therefore the safest bet is to get blood counts every year.

That’s what I would do, and hope that in the best case scenario I was a long term non progressor and that I would live long and then die before the outbreak of the disease. That would be the same thing as getting cured in my opinion.

NathanG
Post 3

@allenJo - HIV did not originate with sexual activity, if that's what you mean. A basic study of HIV history reveals that it started with monkeys in Africa. I know some people scoff at this idea, especially those with a sexual axe to grind who want to blame it all on unprotected sex, but that is the scientific consensus.

As for how the virus can be transmitted, yes, sexual activity is one way, including infected drug transfusions and contaminated needles. I personally don’t believe the method in which one acquired the disease has any effect on whether or not you become a non progressor.

Once HIV is in your system, it takes on a life of its own.

allenJo
Post 2

@SkyWhisperer - I’ve heard that there are people in Africa who are HIV positive but who do not develop AIDS. Could the environment have something to do with it?

I realize this brings back the nature versus nurture argument but it’s certainly something to think about. It could be environment or diet as you said.

I definitely think that a lot of research should be done into these so called “elite” non progressors to find out what’s going on there.

Some people have suggested that HIV causes are not always linked to promiscuous sexual activity. If that is the case, perhaps it’s the cause of the HIV infection which determines the individual’s propensity to develop or not develop full blown AIDS.

SkyWhisperer
Post 1

This is good news indeed, at least on one level. For years I thought that people who were HIV positive would very shortly thereafter develop full-blown AIDS. The fact that there are people out there who have the virus but not AIDS, for many years even, means that there is possibly a cure or even a treatment that can keep AIDS from developing in infected patients.

I personally believe that an HIV non progressor has a strong immune system that is combating the infection. In that respect I think it would be useful to study his diet as well, since diet can contribute to boosting or diminishing the capacity of the immune system.

The idea that perhaps there is a genetic disposition enabling these people to fight off AIDS is not a promising one, at least to me; it means that some people are lucky enough not to get AIDS while others are not so lucky.

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